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대한소화기내시경학회> Clinical Endoscopy> Mucosal Incision-Assisted Endoscopic Biopsy as an Alternative to Endoscopic Ultrasound-Guided Fine-Needle Aspiration/Biopsy for Gastric Subepithelial Tumor

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Mucosal Incision-Assisted Endoscopic Biopsy as an Alternative to Endoscopic Ultrasound-Guided Fine-Needle Aspiration/Biopsy for Gastric Subepithelial Tumor

Cheol Woong Choi , Joo Ha Hwang
  • : 대한소화기내시경학회
  • : Clinical Endoscopy 53권5호
  • : 연속간행물
  • : 2020년 09월
  • : 505-507(3pages)

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  • : 2234-2443
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  • : 2011-2020
  • : 1045


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1Oral Sulfate Solution is as Effective as 2 L Polyethylene Glycol Plus Ascorbic Acid

저자 : Sung Hyun Shin , Kwang An Kwon

발행기관 : 대한소화기내시경학회 간행물 : Clinical Endoscopy 53권 5호 발행 연도 : 2020 페이지 : pp. 503-504 (2 pages)

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2Mucosal Incision-Assisted Endoscopic Biopsy as an Alternative to Endoscopic Ultrasound-Guided Fine-Needle Aspiration/Biopsy for Gastric Subepithelial Tumor

저자 : Cheol Woong Choi , Joo Ha Hwang

발행기관 : 대한소화기내시경학회 간행물 : Clinical Endoscopy 53권 5호 발행 연도 : 2020 페이지 : pp. 505-507 (3 pages)

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3Endoscopic Ultrasound Fine-Needle Biopsy May Contribute to the Diagnosis of Malignant Lymph Nodes

저자 : Mamoru Takenaka , Shunsuke Omoto , Masatoshi Kudo

발행기관 : 대한소화기내시경학회 간행물 : Clinical Endoscopy 53권 5호 발행 연도 : 2020 페이지 : pp. 508-509 (2 pages)

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4Endoscopic Ultrasonography-Guided Gastroenterostomy Techniques for Treatment of Malignant Gastric Outlet Obstruction

저자 : Ryosuke Tonozuka , Takayoshi Tsuchiya , Shuntaro Mukai , Yuichi Nagakawa , Takao Itoi

발행기관 : 대한소화기내시경학회 간행물 : Clinical Endoscopy 53권 5호 발행 연도 : 2020 페이지 : pp. 510-518 (9 pages)

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Gastric outlet obstruction (GOO) can be caused by periampullary malignancies and often leads to a reduction in a patient's quality of life. Recently, endoscopic ultrasonography-guided gastroenterostomy (EUS-GE) using a lumen-apposing self-expandable metal stent (LAMS) has been developed as a minimally invasive and durable endoscopic treatment for GOO. There are three types of EUS-GE technique: (1) the direct technique; (2) device-assisted techniques, such as a balloon catheter, nasobiliary drainage tube, and ultraslim endoscopy; and (3) EUS-guided double balloon-occluded gastrojejunostomy bypass. Previous reports of EUS-GE with LAMS have shown technical and clinical success rates (regardless of technique and etiology) of 87%–100% and 84%–100%, respectively. Studies comparing EUS-GE and surgical gastrojejunostomy have shown similar success rates, reintervention rates, and cost benefits, with a lower rate of early adverse events in EUS-GE. A comparison of EUS-GE and endoscopic enteral stent placement revealed similar technical success rates, but initial clinical success rate was higher and the rate of stent failure requiring reintervention was lower with EUS-GE. Clin Endosc 2020;53:510-518

5Endoscopic Ultrasound-Guided Vascular Procedures: A Review

저자 : Dominic A. Staudenmann , Arthur J. Kaffes , Payal Saxena

발행기관 : 대한소화기내시경학회 간행물 : Clinical Endoscopy 53권 5호 발행 연도 : 2020 페이지 : pp. 519-524 (6 pages)

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Since the 1980s, endoscopic ultrasound has advanced from being purely diagnostic to an interventional modality. The gastrointestinal tract offers an exceptional window for assessing the vascular structures in the mediastinum and in the abdomen. This has led to a rapidly growing interest in endoscopic ultrasound-controlled vascular interventions as a minimally invasive alternative to surgical and radiological procedures. Clin Endosc 2020;53:519-524

6Endoscopic Ultrasound-Guided Pancreatic Duct Drainage: Techniques and Literature Review of Transmural Stenting

저자 : Akira Imoto , Takeshi Ogura , Kazuhide Higuchi

발행기관 : 대한소화기내시경학회 간행물 : Clinical Endoscopy 53권 5호 발행 연도 : 2020 페이지 : pp. 525-534 (10 pages)

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Endoscopic ultrasound-guided pancreatic duct drainage (EUS-PD) has emerged as an option in patients with failure of retrograde access to the pancreatic duct (PD) because of difficulty in cannulation or surgically altered anatomy. This article provides a comprehensive review of the techniques and outcomes of EUS-PD, especially EUS-guided pancreatic transmural stenting. The clinical data derived from a total of 401 patients were reviewed in which the overall technical and clinical success rates were 339/401 (85%, range 63%-100%) and 328/372 (88%, range 76%-100%), respectively. Short-term adverse events occurred in 25% (102/401) of the cases, which included abdominal pain (n=45), acute pancreatitis (n=17), bleeding (n=10), and issues associated with pancreatic juice leakage such as perigastric or peripancreatic fluid collection (n=9). In conclusion, although EUS-PD remains a challenging procedure with a high risk of adverse events such as pancreatic juice leakage, perforation, and severe acute pancreatitis, the procedure seems to be a promising alternative for PD drainage in patients with altered anatomy or unsuccessful endoscopic retrograde pancreatography. Clin Endosc 2020;53:525-534

7Endoscopic Ultrasound-Guided Local Therapy for Pancreatic Neoplasms

저자 : Jun Seong Hwang , Hyun Don Joo , Tae Jun Song

발행기관 : 대한소화기내시경학회 간행물 : Clinical Endoscopy 53권 5호 발행 연도 : 2020 페이지 : pp. 535-540 (6 pages)

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Surgical resection is considered the only treatment option for pancreatic cancer and other pancreatic neoplasms with malignant potential, such as neuroendocrine tumors, mucinous cystic neoplasms, and intraductal papillary mucinous neoplasms. However, only 10%–20% of all patients with pancreatic cancer present with resectable forms of the disease as the symptoms are rarely manifested during the early stages, and the disease tends to progress rapidly. Furthermore, pancreatic surgery is associated with high rates of morbidity and mortality. The development of linear-array endoscopic ultrasound (EUS) techniques has increased the indications of EUS-guided local therapy for pancreatic neoplasms. We assessed the studies that investigated various treatment modalities, such as fine-needle injection, radiofrequency ablation, irreversible electroporation, and radiotherapy, under EUS guidance to better understand the usefulness of these techniques with respect to the efficacy and associated complications. Clin Endosc 2020;53:535-540

8Endoscopic Full Thickness Resection for Gastrointestinal Tumors - Challenges and Solutions

저자 : Hung Leng Kaan , Khek Yu Ho

발행기관 : 대한소화기내시경학회 간행물 : Clinical Endoscopy 53권 5호 발행 연도 : 2020 페이지 : pp. 541-549 (9 pages)

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Standard polypectomy, endoscopic mucosal resection, and endoscopic submucosal dissection (ESD) are established techniques for the treatment of gastrointestinal tumors. However, resection of submucosal tumors via ESD often results in low rates of microscopically margin-negative (R0) resection and high rates of perforation. Endoscopic full thickness resection (EFTR) overcomes this adverse event and aids in the therapeutic management of complex tumors.
Multiple techniques for EFTR have been developed, each with its own advantages and disadvantages. Submucosal tunneling and non-exposed techniques are generally preferable, because the layer of overlying intact mucosa reduces the incidence of intraperitoneal contamination by the gastric fluid and dissemination of the tumor cells. However, adoption of EFTR by endoscopists in clinical practice remains low. The major challenge seems to be the technical difficulty in performing laparoscopic and/or endoscopic suturing using the currently available instruments.
We developed a novel robotic endoscopic platform with suturing capabilities to overcome the technical challenges of suturing. This platform allows easy maneuvering and triangulation of the instruments, thus facilitating endoscopic suturing using robotic arms. Our studies have demonstrated that this robotic endoscopic platform with suturing capabilities is an effective and safe method for performing EFTR with endoscopic suturing. Clin Endosc 2020;53:541-549

9Colon Capsule Endoscopy for Inflammatory Bowel Disease

저자 : Naoki Hosoe , Yukie Hayashi , Haruhiko Ogata

발행기관 : 대한소화기내시경학회 간행물 : Clinical Endoscopy 53권 5호 발행 연도 : 2020 페이지 : pp. 550-554 (5 pages)

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Colon capsule endoscopy was initially introduced in 2006. Since the results of a prospective study to evaluate first-generation colon capsule endoscopy efficacy for the detection of colonic neoplasia were unsatisfactory, second-generation colon capsule endoscopy was developed and reported in 2009. In this review article, we provide an overview of the current state of colon capsule endoscopy for evaluation of inflammatory bowel disease in a clinical setting and describe our clinical experience with this technology and its application. Among the various types of inflammatory bowel diseases, ulcerative colitis is the primary target for application of colon capsule endoscopy. Nevertheless, the initial results of studies using first-generation colon capsule endoscopy to evaluate inflammation were unclear. More recently, second-generation colon capsule endoscopy has provided higher accuracy for assessment of inflammation in patients with ulcerative colitis. Colon capsule endoscopy enables noninvasive observation (with reduced volume preparation) of mucosal inflammation severity in patients with ulcerative colitis. Clin Endosc 2020;53:550-554

10Efficacy and Safety of Etomidate in Comparison with Propofol or Midazolam as Sedative for Upper Gastrointestinal Endoscopy

저자 : Jae Hyun Kim , Sanghwan Byun , Youn Jung Choi , Hye Jung Kwon , Kyoungwon Jung , Sung Eun Kim , Moo In Park , Won Moon , Seun Ja Park

발행기관 : 대한소화기내시경학회 간행물 : Clinical Endoscopy 53권 5호 발행 연도 : 2020 페이지 : pp. 555-561 (7 pages)

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Background/Aims: In this study, we compared the efficacy and safety of etomidate with those of propofol or midazolam for the maintenance of sedation during endoscopy.
Methods: The study enrolled patients who underwent sedative endoscopy in our hospital and divided them into three groups. Patients in each group were administered midazolam as induction therapy and were subsequently administered either midazolam (M + M group), propofol (M + P group), or etomidate (M + E group) as maintenance medication. The primary outcome was overall cardiovascular and respiratory adverse events.
Results: In total, 105 patients who underwent sedative endoscopic examination were enrolled. The outcomes related to the procedure and sedation were not significantly different among the groups. Overall cardiovascular and respiratory adverse events were observed in 9 patients (25.7%) in the M + M group, 8 patients (23.5%) in the M + P group, and 10 patients (27.8%) in the M + E group. The logistic regression analysis revealed that etomidate use was not an independent risk factor for overall cardiovascular and respiratory adverse events.
Conclusions: The outcomes following the use of etomidate for maintenance after induction with midazolam for sedation in upper gastrointestinal endoscopy were not inferior to those following midazolam or propofol use from the perspectives of safety and efficacy. Clin Endosc 2020;53:555-561

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